By Tia Ghose
A woman who had persistent headaches found there was a strange culprit for her pain: a Pilates class that caused her brain fluid to leak, according to a new case report.
The brain fluid leak led to a persistent, worsening headache that was only alleviated when the 42-year-old British woman laid down, according to the report that was published in December in the Journal of Medical Case Reports.
Though doctors never identified the exact location of the leak, the patient improved after a few weeks of bed rest and pain relievers. [The 16 Oddest Medical Cases]
Cerebrospinal fluid is a clear liquid that flows between the brain and its outer covering, and between the spinal cord and its outer covering. Both of these structures' outer coverings are called the dura. This fluid cushions the brain and spinal cord and helps clear metabolic waste from the brain. However, sometimes holes can emerge in the dura, said Dr. Amber Luong, an otolaryngologist at the University of Texas Health Sciences Center in Houston.
"The most common cause [of such leaks is] trauma, like a car accident," Luong told Live Science. Often, cerebrospinal fluid leaks out of a person's nose because there is a crack in the base of the skull and a tear in the dura lining the brain.
One telltale sign of a cerebrospinal leak is that there is clear, metallic-tasting fluid coming out of just one nostril, Luong said. (The woman in this case did not experience this symptom because her tear was around the spinal cord, not the brain.)

By Amy Ellis Nutt
Scientists have discovered what a traumatic brain injury, or TBI, suffered by a quarter-million combat veterans of Iraq and Afghanistan looks like, and it’s unlike anything they’ve seen before: a honeycomb pattern of broken connections, primarily in the frontal lobes, our emotional control center and the seat of our personality.
“In some ways it’s a 100-year-old problem,” said Vassilis Koliatsos, a Johns Hopkins pathologist and neuropsychiatrist. He was referring to the shell-shock victims of World War I, tens of thousands of soldiers who returned home physically sound but mentally wounded, haunted by their experiences and unable to fully resume their lives.
“When we started shelling each other on the Western Front of World War I, it created a lot of sick people . . . . [In a way,] we’ve gone back to the Western Front and created veterans who come back and do poorly, and we’re back to the Battle of the Somme,” he said. “They have mood changes, commit suicide, substance abuse, just like in World War I, and they really do poorly and can’t function. It’s a huge problem.”
Many of the lingering symptoms of shell shock, or what today is known as neurotrauma, are the same as they were a century ago. Only the nature of the blast has changed, from artillery to improvised explosive devices.
Koliatsos and colleagues, who published their findings in the journal Acta Neuropathologica Communications in November, examined the brains of five recent U.S. combat veterans, all of whom suffered a traumatic brain injury from an IED but died of unrelated causes back home. Their controls included the brains of people with a history of auto accidents and of those with no history of auto accidents or TBI. Koliatsos says he was prompted to do this study because he is both a pathologist and a neuropsychiatrist, and he sees many TBI cases, both in veterans and in young people with sports concussions.